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Chinese City Children and Youth Physical Activity Study: An Introduction Peijie Chen

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Shanghai University of Sport Published online: 04 Dec 2013.

To cite this article: Peijie Chen (2013) Chinese City Children and Youth Physical Activity Study: An Introduction, Research Quarterly for Exercise and Sport, 84:sup2, S1-S3, DOI: 10.1080/02701367.2013.851162 To link to this article: http://dx.doi.org/10.1080/02701367.2013.851162

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Research Quarterly for Exercise and Sport, 84, S1–S3, 2013 Copyright q AAHPERD ISSN 0270-1367 print/ISSN 2168-3824 online DOI: 10.1080/02701367.2013.851162

Chinese City Children and Youth Physical Activity Study: An Introduction Peijie Chen

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Shanghai University of Sport

Children today are becoming fat and less fit! The problem is global and is steadily affecting many low- and middleincome countries, particularly in urban settings. According to a meta-analysis by Tomkinson and Olds (2007), aerobic performances have declined globally at a rate of 2 0.46% per year since 1970. At the same time, the prevalence of childhood obesity has increased at an alarming rate. Worldwide, the number of overweight children younger than age 5 in 2010 was estimated to be more than 42 million. Sadly, close to 35 million of these children are living in developing countries. It is well known that overweight and obese children are very likely to remain obese into adulthood and are more likely to develop noncommunicable diseases like diabetes and cardiovascular disease, even at a younger age. Childhood obesity and its repercussions thus will be one of the most serious public health challenges of the 21st century. Promoting physical activity and preventing the decline of children’s fitness and the increase of childhood obesity therefore need to be a high priority. Looking at our knowledge of children’s physical fitness and obesity, the data on secular trends in children’s physical activities are very limited. Dollman, Norton, and Cleland (2005) stated: “... so how can we tell if children are less physically active now than in previous generations? There is no one measure to give us the answer” (p. 892). This is true especially concerning information about children’s physical activity levels in developing countries. So far, besides a few large-scale studies conducted in developed countries such as the United States, Australia, and European countries, few have been conducted or reported in other countries, including China, a country with 20% of the world’s population. Although there has been a well-developed youth physical fitness surveillance system in China, no major

Correspondence should be addressed to Peijie Chen, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, P. R. China. E-mail: [email protected]

national study has been conducted there to measure children’s physical activity until recently. Sponsored by the Chinese National Science & Technology Pillar Program, a major national physical activity survey study called Chinese City Children and Youth Physical Activity Study (CCCYPAS), which I directed, was completed recently. Specifically, between April 2011 and May 2012, physical activities of a total of 3,121 healthy children and youth (1,603 boys and 1,518 girls; Grades 4– 11) from 11 cities in China were surveyed using ActiGraph accelerometers. The participating cities include Chengdu, Fuyang, Ganzhou, Guangzhou, Shanghai, Shenyang, Tianjin, Tongzhou, Wenzhou, Xian, and Yingtan, which are spread across China. Major steps of the CCCYPAS included: 1. Forming and training the research team. A research team was first formed at the Shanghai University of Sport (SUS), and the team members were trained extensively for the purpose of this study in research ethics, data collection protocol, device calibration, data processing and saving, and other related issues. One or two exercise science institutes or departments in each of the targeted cities were then contacted to assist in the data collection. Upon agreement to participate, a data collection team was then formed at the local institute or department and was trained by the SUS team. 2. Getting the human research protocol approved. The methods and the protocols of CCCYPAS were submitted to and approved by the Ethical Advisory Committee of SUS. 3. Recruiting participants. Two to four public schools in each participating city were recruited to take part in the study. Participating students and their parents were informed of the purposes and protocol of the study, and written informed assent was obtained from all participants as was written informed consent from their parents or guardians.

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4. Data collection. Participants were instructed to wear the accelerometers for 7 consecutive days on the right hip and secured by an elastic belt. They were asked to wear the devices when they were awake and to take the device off when swimming, bathing, and sleeping. Researchers collected the accelerometers after 8 days to ensure 7 days of complete data collection. Verbal or written instructions were given to all participants and their parents/guardians to remind them to wear the accelerometer to increase compliance. The participants were also asked to follow their normal daily routines during the monitoring period. 5. Data analysis and preparing reports. A total of 3,121 Chinese children and youth (1,603 boys and 1,518 girls; aged 9 –17 years old) participated in the study. Researchers analyzed the data using both descriptive and inferential statistics and generated study reports accordingly. In addition to the key findings of the CCCYPAS, such as daily moderate-to-vigorous physical activity (MVPA) minutes and number of daily steps taken by Chinese city children and youth, several measurement and analytical studies were completed simultaneously using the CCCYPAS sample or data. Publishing the findings of these studies in English will not only inform the world for the first time of the physical activity status of Chinese city children and youth, but it will also hopefully make a meaningful contribution to the literature regarding physical activity participation of children and youth around the world and its related issues. A total of nine articles are included in this supplement. The first two studies focused on determining the number of daily MVPA minutes in which children and youth engaged through the use of accelerometers. To do so, the classification of physical activity must be first determined. In the first study, Zhu, Chen, and Zhuang (this supplementa) developed a set of cutoff points, which were then compared to published cutoff points. Because these newly developed cutoff points were demonstrated to be more accurate than published cutoff points, they were used in the second study by Wang, Chen, and Zhuang (this supplementa), who reported that only 17.0% of Chinese children and youth (22.6% of boys and 11.3% of girls) met the physical activity recommendations of at least 60 min of MVPA per day. Girls spent less time in moderate physical activity, vigorous physical activity, and MVPA than did boys, and older students were less active and more sedentary. The low physical activity participation observed by Wang et al. was further confirmed in the third article by Quan, Chen, Zhuang, and Wang (this supplement). By comparing their findings to three commonly used criteria (i.e., Tudor-Locke et al., 2011; Tudor-Locke et al., 2004; Colley, Janssen, & Tremblay, 2012) for needed daily steps to maintain health, Quan et al. reported that only 20.61%, 39.47%, and 30.04%

Chinese boys, and 33.32%, 35.41%, and 25.36% Chinese girls, met the recommendations. As reported in many studies, we also experienced some challenges in dealing with missing data. The fourth and fifth studies focused on missing data in physical activity research. In the first of these two studies, Zhuang, Chen, Wang, Huang, et al. (this supplement) carefully examined characteristics of missing physical activity data in children and youth. Based on our knowledge, this is one of few studies so far to examine the characteristics of missing physical activity data. In the fifth study, Zhuang, Chen, Wang, Jin, et al. (this supplement) examined the best way to recover missing physical activity data using a semisimulation design, and they concluded that to recover 7-day missing physical activity data, the group-centered expectation maximization approach should be used. Accurately measuring or predicting physical activity energy expenditure is still an unsolved problem. The sixth through eighth studies joined the effort to explore solutions. In the sixth study, Zhu, Chen, and Zhuang (this supplement-b) derived an energy expenditure (EE) prediction equation using ActiGraph accelerometers with good accuracy at R 2 ¼ .72, SEE ¼ 1.45 kcal/min. The cross-validation study indicated the equation performed better than previously published equations, although none could accurately predict a specific physical activity. In the seventh article, Sun, Liu, Li, Li, and Chen (this supplement) had a very similar interest in EE prediction but focused on step frequency during walking and running. They concluded that age and gender factors should be considered in the establishment of regression equations to predict energy expenditure based on step frequency of walking and running to make the prediction more reliable. In the eighth article, Huang, Chen, Zhuang, Zhang, and Walt (this supplement) focused on EE, mechanical work, and efficiency during normal walking in obese and normal-weight children. They found that body mass plays a dominant role in total metabolic and mechanical cost per stride and that obese children used an adaptive walking strategy to avoid increase in metabolic cost and the mechanical work required to lift, lower, accelerate, and decelerate their body center of mass. Finally, in the ninth study, Wang, Chen, and Zhuang (this supplement-b) examined the validity and reliability of the International Physical Activity Questionnaire –Short Form (IPAQ –SF) using the CCCYPAS data. As expected, the convergent validity examined was very low (r ¼ .18 –.31) and the reliability of the IPAQ – SF varied from low to high (intraclass correlation coefficient ¼ .32– .82). The researchers concluded that the current version of the IPAQ – SF did not appear to be a worthwhile physical activity assessment tool for Chinese youth. To complete such a large study and publish its major findings in such an honorable journal would have been impossible without help from many people. I would like take this opportunity to thank:

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PHYSICAL ACTIVITY IN CHINESE CHILDREN AND YOUTH

1. The Chinese National Science & Technology Pillar Program (Serial Number: 2009BAK62B01) for its funding support and for being a great supporting resource for the CCCYPAS; 2. The research teams at SUS including Jie Zhuang, Chao Wang, Zheng Zhu, Wenjie Zhang, Minghui Quan, and the rest of the team members for their dedicated time and work on this study; 3. The leaders of the research teams and schools in the collaborating cities for their assistance and support throughout: . Chengdu: Prof. Qiongjia Yuan at the Chengdu Sport University and Dr. Tao Wang at the Chengdu University of Information Technology . Fuyang: Prof. Zicai Duan at the Fuyang Normal College . Ganzhou: Prof. Guocheng Yang & Rong Chen at the East China Jiaotong University . Guangzhou: Prof. Lin Zhu at the Guangzhou Sport University . Shanghai: Dr. Jie Zhuang at the SUS and Mr. Yang Yang at the Shanghai Municipal Center for Students’ Physical Fitness and Health Surveillance . Shenyang: Prof. Bo Chang and Prof. Xuejie Yi at the Shenyang Sport University . Tianjin: Prof. Sijie Tan at the Tianjin University of Sport . Tongzhou: Prof. Biao Sun and Dr. Jiansong Dai at the Nanjing Sport Institute . Wenzhou: Prof. Qing Teng at the Wenzhou Medical University . Xian: Prof. Bo Gou at the Xi’an Physical Education University . Yingtan: Prof. Wenying Huang at the Jiangxi Normal College; 4. Schools and students for their participation in the study; 5. The editorial board of Research Quarterly for Exercise and Sport (RQES) and the American Alliance for Health, Physical Education, Recreation and Dance for supporting the publication of the CCCYPAS findings in RQES; 6. The reviewers, who provided excellent comments and suggestions on earlier drafts of the articles, which significantly helped improve the quality of the articles; and 7. Finally, Dr. Weimo Zhu, the editor in chief of RQES, and Ms. Heidi Krahling, RQES editorial coordinator, for their endless hours of advice, assistance, and editorial support. In summary, the success of the 2008 Beijing Olympics alerted the world about China’s excellence in sport. Yet, exercise science research activities and findings were basically kept

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inside China. The CCCYPAS published in this supplement marks the first major attempt to introduce research studies conducted in China to the world. I hope you enjoy the supplement, and I welcome your comments and suggestions because I know there are still many limitations in the current studies. Finally, on behalf of SUS, we are looking forward to more opportunities for cultural exchange and research collaborations with exercise and sport research communities worldwide. REFERENCES Colley, R. C., Janssen, I., & Tremblay, M. S. (2012). Daily step target to measure adherence to physical activity guidelines in children. Medicine and Science in Sports and Exercise, 44, 977– 982. doi:10.1249/ MSS.0b013e31823f23b1 Dollman, J., Norton, K., & Cleland, V. (2005). Evidence for secular trends in children’s physical activity behaviour. British Journal of Sports Medicine, 39, 892–897. Huang, L., Chen, P., Zhuang, J., Zhang, Y., & Walt, S. (this supplement). Metabolic cost, mechanical work, and efficiency during normal walking in obese and normal-weight children. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Quan, M., Chen, P., Zhuang, J., & Wang, C. (this supplement). Chinese city children and youth’s walking behavior. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Sun, B., Liu, Y., Li, J. X., Li, H., & Chen, P. (this supplement). Prediction equations of energy expenditure in Chinese youth based on step frequency during walking and running. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Tomkinson, G. R., & Olds, T. S. (2007). Secular changes in pediatric aerobic fitness test performance: The global picture. Medicine and Sport Science, 50, 46 –66. Tudor-Locke, C., Craig, C. L., Beets, M. W., Belton, S., Cardon, G. M., Duncan, S., & Blair, S. N. (2011). How many steps/day are enough? for children and adolescents. The International Journal of Behavioral Nutrition and Physical Activity, 8, 78– 91. doi:10.1186/1479-5868-8-78 Tudor-Locke, C., Pangrazi, R. P., Corbin, C. B., Rutherford, W. J., Vincent, S. D., Raustorp, A., . . . Cuddihy, T. F. (2004). BMI-referenced standards for recommened pedometer-determined steps/day in children. Preventive Medicine, 38, 857–864. doi:10.1016/j.ypmed.2003.12.018 Wang, C., Chen, P., & Zhuang, J. (this supplement-a). A national survey of physical activity and sedentary behavior of Chinese city children and youth using accelerometers. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Wang, C., Chen, P., & Zhuang, J. (this supplement-b). Validity and reliability of International Physical Activity Questionnaire–Short Form in Chinese youth. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Zhu, Z., Chen, P., & Zhuang, J. (this supplement-a). Intensity classification accuracy of accelerometer-measured physical activities in Chinese children and youth. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Zhu, Z., Chen, P., & Zhuang, J. (this supplement-b). Predicting Chinese children’s and youth’s energy expenditure using ActiGraph accelerometers: A calibration and cross-validation study. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Zhuang, J., Chen, P., Wang, C., Huang, L., Zhu, Z., Zhang, W., & Fan, X. (this supplement). Characteristics of missing physical activity data in children and youth. Research Quarterly for Exercise and Sport, 84(Suppl. 2). Zhuang, J., Chen, P., Wang, C., Jin, J., Zhu, Z., & Zhang, W. (this supplement). Recovering physical activity missing data measured by accelerometers: A comparison of individual and group-centered recovery methods. Research Quarterly for Exercise and Sport, 84(Suppl. 2).

Chinese city children and youth physical activity study: an introduction.

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